Surgeries require much preparation and standardization of procedures. One of the areas where preparation is especially helpful is in assembly and organization of surgical instruments, surgical textiles, and devices that are to be used during a surgery or within a surgical environment. A major concern is the sterilization and the maintenance of sterilization of those surgical instruments and devices. Sterilization is a process which achieves the complete destruction or killing of all microorganisms, including bacterial spores.
Sterilization can be accomplished by, for example, the use of steam under pressure (autoclaving), the use of dry heat (hot air oven), and/or the use of chemicals such as ethylene oxide gas (which is mainly used in industry) or other low temperature methods (e.g., hydrogen peroxide gas plasma). Sterilization through the use of steam under pressure can have several advantages in providing sterilized surgical instruments and devices. Such sterilization using an autoclave can be highly effective and can provide rapid heating and rapid penetration of instruments. Such sterilization can also be nontoxic and inexpensive.
Steps of sterilization through the use of steam under pressure, for example, in an autoclave, can include cleaning all surgical instruments and devices to be sterilized. To begin, the surgical instruments, surgical textiles, and devices can be opened or unlocked at the hinges of hinged items and/or disassembled for items with multiple pads. All labeled packs, drums, or unwrapped items in the chamber of the autoclave can be arranged in a way that allows the steam to circulate freely. Once the steam has circulated under the correct temperature and pressure for the correct amount of time, the steam can be released and the items left to dry completely. Items such as packs, drums or unwrapped items should be handled with sterile instruments after they have cool to room temperature.
For unwrapped items, use needs to be immediately after removal from the autoclave. Alternatively, such items need to be kept in a covered, dry, sterile container that can be stored for later use. To better preserve the sterilization, surgical instruments and devices can be wrapped beforehand and then sterilized. Wrapping instruments and other items before steam sterilization helps to decrease the likelihood that, after sterilization, they will be contaminated before use.
For wrapped items, the length of time of storage (i.e., shelf life) that a wrapped, sterile item is considered sterile depends on whether or not a contaminating event occurs not necessarily on how long an item has been stored. Items should be stored in a closed, dry, cabinet with moderate temperature and low humidity in an area that is not heavily trafficked. A wrapped pack can be considered sterile as long as it remains intact and dry.
The materials used to wrap instruments can vary widely in their type and effectiveness. Most of these wrappers are single use disposable and their shelf life can vary greatly. Further, for both disposable and non-disposable wrappers, the wrappers are often dyed to specific colors. For instance, wrappers can be dyed to match the color the surgical scrubs and/or other linens used in an operating room. For example, the wrappers can be dyed to match the color of the surgical scrubs and linens (hues of blue, green and pink). In such colored surgical wrappers, the dye used to color the wrappers in some instances can be released and transferred from the fabrics used in the wrappers when the wrappers are exposed to the intense pressures, moisture and temperatures during steam sterilization. Thus, dye, color, or colorant material transfer occurs, which is undesirable, but the dye or color that is transferred can pool on the instruments, textiles and containers within the sterilized wrappers. While the instruments are still sterile and completely safe for use, the undesirable color on the instruments can be disconcerting to surgeons and operating room staff. A need exists for a reusable surgical wrapper that can facilitate steam sterilization, provide appropriate shelf life for sterilized items and not be subject to color transfer.